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Description
Claims adjudication services cover a range of areas including medical, dental, vision, and prescription claims, as well as short and long-term disability cases. These services can be accessed either on-site with a license or through a hosted application model (ASP). Utilizing Microsoft technology, the system is powered by an SQLServer database paired with a Windows front end. Our customer service is highly regarded, staffed by healthcare claims professionals who boast a minimum of 12 years of industry experience. All support inquiries are recorded, and their statuses can be monitored online. The system features a plan copy and modification tool that facilitates rapid plan implementation. Auto-adjudication is achieved through benefit codes that are constructed using business rules derived from over 25 variables connected to both the claims and the claimants, which are then processed by the adjudication engine. Claims can be submitted in various formats, including scanned images, EDI, or paper submissions. The system is compliant with HIPAA EDI 5010 transaction sets, ensuring secure and efficient processing. Additionally, re-pricing fees and UCR schedules can be pre-loaded into the system prior to their effective dates, while the date-driven logic ensures that re-pricing occurs based on the service date, optimizing the claims processing workflow. The comprehensive nature of this system allows for a more streamlined and efficient claims management experience.
Description
MarvelX is an agentic AI company for financial services and other highly regulated industries, with insurance as its flagship vertical. Its AI claims agents are built for autonomous claims processing: a claim comes in as a first notice of loss (FNOL), the policy is validated, the claim is adjudicated, and settlement follows, bringing handling time down from days to under an hour. Claims teams at P&C, motor, travel, health, life, and embedded insurers, as well as MGAs and TPAs, use MarvelX to confirm policy details, verify that a claim file is complete, and hand edge cases to a human reviewer. A person stays in the loop on every decision, and each outcome is documented for audit. A standalone workflow, AI document data extraction for insurance, serves teams that want structured fields out of insurance documents, traceable to a source reference, with no decisioning attached. The same architecture is being applied to other regulated work, KYC/KYB verification for notarial services among them. Integrations cover HubSpot and the Dutch registries KVK, RDW, and SchadeGarant, so MarvelX fits the systems a claims operation already runs.
API Access
Has API
API Access
Has API
Integrations
HubSpot CRM
Pricing Details
No price information available.
Free Trial
Free Version
Pricing Details
Price on request
Pricing is scoped to claim volume and workflows deployed. Get in touch for a quote.
Free Trial
Free Version
Deployment
Web-Based
On-Premises
iPhone App
iPad App
Android App
Windows
Mac
Linux
Chromebook
Deployment
Web-Based
On-Premises
iPhone App
iPad App
Android App
Windows
Mac
Linux
Chromebook
Customer Support
Business Hours
Live Rep (24/7)
Online Support
Customer Support
Business Hours
Live Rep (24/7)
Online Support
Types of Training
Training Docs
Webinars
Live Training (Online)
In Person
Types of Training
Training Docs
Webinars
Live Training (Online)
In Person
Vendor Details
Company Name
Complete Health Systems
Website
completehealthsys.com/claims/
Vendor Details
Company Name
MarvelX.ai
Founded
2025
Country
Netherlands
Website
www.marvelx.ai
Product Features
Claims Processing
Adjustor Management
Case Management
Claim Resolution Tracking
Co-Pay & Deductible Tracking
Compliance Management
Customer Management
Electronic Claims
Forms Management
Paper-Based Claims
Payor Management
Policy Administration
Product Features
Claims Processing
Adjustor Management
Case Management
Claim Resolution Tracking
Co-Pay & Deductible Tracking
Compliance Management
Customer Management
Electronic Claims
Forms Management
Paper-Based Claims
Payor Management
Policy Administration